The aims of this proposal are to (1) enable the candidate to further develop his program ofoutcomes research in the elderly, focused on the evaluation of prognostic factors, the development and validation of prognostic stratification tools, and the application of prognosis to clinical decision making and (2) Use his research program as a platform to mentor trainees interested in careers in aging research, both within Geriatric medicine and in the medical subspecialties. The candidate is at an ideal stage of his career for a K24. In the 12 years since the completion of his training, he has established a productive and high impact clinical research program that is well funded with an outstanding publication record. In the past 7 years, he has established himself as a successful mentor of Geriatrics fellows, who have also published high impact research and become successfully funded. This proposal will provide the candidate the protected time to advance his research program in new novel directions, and develop formal mentoring programs that will enable to him to expand the scope of his mentoring activities which are currently narrowly focused on the UCSF Geriatrics fellowship. He will advance his work on prognosis, by conducting work that takes a more life course view of prognosis by examining the determinants of mortality and functional deterioration over long time intervals, considering how changes in health status can be used to predict outcomes, and developing indices to predict exceptional health outcomes. He will also initiate a new project that develops prognostic stratification tools for frail nursing home eligible elders who continue to live in the community. He will also develop a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become leaders in aging research. Each mentee will have a focused career development plan in which they complete a research project and develop skills needed to become independent investigators. The candidate will continue to mentor Geriatrics trainees and junior faculty, but also diversity his mentoring portfolio by training clinician investigators outside of Geriatrics who seek to become leaders in aging research within their own disciplines. This proposal integrates the candidate's mentoring program into an already outstanding clinical research training environment at UCSF, building on an outstanding didactic training program, as well the UCSF K30 and Roadmap K12 and CTSI programs.